Internal Medicine and Preventive Medicine Combined Program, Griffin Hospital, Derby, CT, USA.
Am J Health Syst Pharm. 2012 Sep 1;69(17):1494-9. doi: 10.2146/ajhp110675.
The efficacy of statins in combination with interferon therapy in patients with multiple sclerosis (MS) is reviewed.
A systematic literature search was conducted through September 2011 to identify randomized controlled trials that evaluated the effect of combination statin-interferon therapy compared with interferon therapy alone in patients with MS. Trials had to report at least one of the following outcomes of interest: clinical relapse rate, disease progression, or Expanded Disability Status Scale (EDSS) score. A random-effects model was used to pool data. Trial quality was assessed using the Jadad score.
Four unique trials were included in the analysis (n = 463 subjects; range of follow-up, 9-24 months), all with a Jadad score of ≥3. All trials evaluated patients with relapsing-remitting MS (RRMS). Most trials enrolled patients taking interferon beta therapy either twice or three times weekly. The mean baseline EDSS scores ranged from 1.2 to 3.4. Evaluated statins included simvastatin and atorvastatin. No significant difference was found between the statin and control groups in the incident rate ratio for clinical relapse (0.72; 95% confidence interval [CI], 0.17 to 3.11), risk of relapse (relative risk [RR], 0.99; 95% CI, 0.53 to 1.85], disease progression (RR, 1.31; 95% CI, 0.73 to 2.36), or difference in the change in the EDSS score from baseline (weighted mean difference, -0.06; 95% CI, -0.30 to 0.19).
A meta-analysis revealed that the addition of statins to interferon therapy did not significantly influence the relapse risk, disease progression, or EDSS scores in patients with RRMS.
综述他汀类药物与干扰素联合治疗多发性硬化症（MS）的疗效。
通过 2011 年 9 月进行系统文献检索，以确定评估他汀类药物与干扰素联合治疗与单独干扰素治疗相比在 MS 患者中的效果的随机对照试验。试验必须报告以下至少一个感兴趣的结果之一：临床复发率、疾病进展或扩展残疾状况量表（EDSS）评分。使用随机效应模型对数据进行汇总。使用 Jadad 评分评估试验质量。
分析中纳入了四项独特的试验（n=463 例；随访时间范围为 9-24 个月），Jadad 评分均≥3 分。所有试验均评估了接受干扰素β治疗的复发性缓解型 MS（RRMS）患者。大多数试验纳入每周接受两次或三次干扰素β治疗的患者。基线 EDSS 评分的平均值范围为 1.2 至 3.4。评估的他汀类药物包括辛伐他汀和阿托伐他汀。他汀类药物组与对照组的临床复发发生率比（0.72；95%置信区间[CI]，0.17 至 3.11）、复发风险（相对风险[RR]，0.99；95%CI，0.53 至 1.85）、疾病进展（RR，1.31；95%CI，0.73 至 2.36）或 EDSS 评分从基线变化的差异（加权均数差，-0.06；95%CI，-0.30 至 0.19）均无显著差异。
荟萃分析显示，在 RRMS 患者中，将他汀类药物加入干扰素治疗并未显著影响复发风险、疾病进展或 EDSS 评分。
